SUCCESSFUL TREATMENT OF ACUTE PROMYELOCYTIC LEUKEMIA WITH ALL-TRANS-RETINOIC-ACID DURING LATE PREGNANCY

We describe a patient with acute promyelocytic leukaemia (PML) diagnos ed in the third trimester of pregnancy who presented with coagulopathy and prolonged bleeding time. Treatment with all-trans-retinoic-acid ( ATRA) resulted in rapid normalization of the coagulopathy and complete remission of PML within 2 weeks. Induced labour resulted in an uneven tful vaginal delivery without major blood loss with no signs of neonat al ATRA-induced embryopathy. ATRA therapy for PML during late pregnanc y was effective in reversing the maternal bleeding tendency and induci ng a complete remission of the PML without evidence of teratogenicity. Careful monitoring of bleeding time is important, even after normaliz ation of clotting parameters and thrombocyte count, for determining th e moment of induction of labour.